Objective To investigate effects of calycosin(CA)on cigarette smoke(CS)induced airway epithelial cell damage in mice and the sirtuin 3/superoxide dismutase 2(SIRT3/SOD2)signaling pathway in mice.Methods A total of 90 mice were randomly separated into the control group,the cigarette smoke(CS)group,the CA low-dose treatment group(CA-L group),the CA high-dose treatment group(CA-H group)and the CA high-dose treatment plus SIRT3 inhibitor 3-TYP group(CA-H+3-TYP group),with 18 mice in each group.Tidal volume(TV)and peak expiratory flow rate(PEF)of lung function were detected by whole body plethysmography system.Serum levels of inflammatory factors[interleukin(IL)-6,tumor necrosis factor(TNF)-α]and oxidative stress indicators[reactive oxygen species(ROS),SOD]were detected by enzyme-linked immunosorbent assay(ELISA).The injury of airway epithelial cells in lung tissue was observed by HE staining.The expression levels of barrier related proteins(OCLN and ZO-1)in airway epithelial cells were detected by immunohistochemistry.Immunoblotting was applied to detect the expression of SIRT3/SOD2 signaling pathway related proteins.Results Compared with the control group,levels of TV,PEF,MAN and SOD and the expression levels of OCLN,ZO-1,SIRT3 and SOD2 were decreased in the CS group,while the levels of MLI,IL-6,TNF-α and ROS were increased(P＜0.05).Compared with the control group,the lung tissue structure was significantly damaged,the alveolar enlargement was obvious,the surrounding alveolar was accompanied by inflammatory cell infiltration,and the airway epithelial cells were obviously shed in the CS group.Different doses of CA alleviated lung tissue destruction,improved alveolar structure,reduced inflammatory cell infiltration,reduced airway epithelial cell shedding,increased levels of TV,PEF,MAN,SOD and OCLN,ZO-1,SIRT3 and SOD2,and decreased levels of MLI,IL-6,TNF-α and ROS.The effect of high dose CA was more significant than that of low dose CA(P＜0.05).SIRT3/SOD2 signaling pathway inhibitor 3-TYP partially reversed the ameliorative effect of CA on CS induced airway epithelial cell injury in mice.Conclusion CA can ameliorate CS induced airway epithelial cell damage in mice,and its mechanism is related to the activation of the SIRT3/SOD2 signaling pathway.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective:To explore the serological characteristics and genetic variant in a Chinese pedigree with Bw subtype.Methods:A 32-year-old female proband who had undergone prenatal examination on December 10, 2020 at the 960th Hospital of the PLA Joint Logistics Support Force and five members from her pedigree were selected as the study subjects. Peripheral blood samples were collected and subjected to ABO blood group phenotyping with serological methods and ABO blood group genotyping with fluorescent PCR. Genetic testing and haplotype analysis were carried out by direct sequencing of the entire coding region of the ABO gene in the proband and cloned sequencing of exons 1-7. Results:The blood type serology of the proband showed Bw, and the ABO blood type genotype determined by fluorescence PCR was B/O. The direct sequencing results showed that the proband had matched the ABO* O. 01. 01/ ABO* B. 01 genotype and carried a c. 1A>G variant. Cloned sequencing has confirmed the c. 1A>G variant to have occurred in the ABO* B. 01 allele. Family analysis revealed that the mother of the proband had an O blood type, her husband had a B phenotype, and the her three children had a normal B blood type. DNA sequencing showed that the two sons of the proband had a genotype of ABO* B. 01 and c. 1A>G/ ABO* B. 01. The daughter of the proband was ABO* O. 01. 01/ ABO* B. 01, whilst her mother was ABO* O. 01. 01/ ABO * O. 01. 02. The novel c. 1A>G variant sequence has been registered with the database with a number of MZ076785 1. Conclusion:The novel c. 1A>G variant of exon 1 of α- 1, 3 galactose aminotransferase gene probably underlay the reduced expression of B antigen in this pedigree.

Objective To investigate the distribution of pathogens causing pulmonary infection after lung cancer chemotherapy and the changes and diagnostic value of serum cytokeratin 19 fragment antigen (CYFRA21-1), high mobility group box 1 protein (HMGB1), and soluble hemoglobin scavenger receptor (sCD163) levels. Methods A total of 83 lung cancer patients with chemotherapy from July 2022 to November 2023 were divided into non-infected group (n=43) and infected group (n=40) based on their pulmonary infection status, sputum samples were collected from lung cancer chemotherapy patients, and the source of the samples was recorded for bacterial identification.The changes in serum CYFRA21-1, HMGB1 and sCD163 levels were compared between the two groups; a multivariate Logistic regression model was used to analyze the factors influencing pulmonary infection after lung cancer chemotherapy; the diagnostic values of serum CYFRA21-1, HMGB1 and sCD163 levels for pulmonary infection after lung cancer chemotherapy were analyzed. Results Among the 83 patients with lung cancer chemotherapy, 40 cases had pulmonary infections; a total of 55 strains of pathogens were detected, including 34 Gram-negative bacteria and 18 Gram-positive bacteria, accounting for 61.82% and 32.73% respectively, while only 3 strains of fungi were detected, accounting for 5.45%.Serum levels of CYFRA21-1, HMGB1 and sCD163 in the infected group were significantly higher than those in the non-infected group (P < 0.05).Age, history of lung diseases, CYFRA21-1, HMGB1 and sCD163 were factors influencing pulmonary infection in patients with lung cancer chemotherapy (P < 0.05).The areas under the curve for the diagnostic value of serum CYFRA21-1, sCD163 and HMGB1 levels for pulmonary infection after lung cancer chemotherapy were 0.677, 0.763 and 0.819, respectively (P < 0.05). Conclusion The main pathogens causing pulmonary infection after lung cancer chemotherapy are Gram-negative bacteria, and the serum levels of CYFRA21-1, HMGB1 and sCD163 increase significantly, which can be used as biological indicators for early diagnosis and assessment of infection.

Humans ; Asthma/drug therapy* ; Biological Therapy

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Objective:To study the serological and molecular biological characteristics and differences of occult hepatitis B infection (OBI) between blood donors and chronic hepatitis B (CHB) patients.Methods:Nineteen OBI samples from blood donors and Nineteen OBI samples from CHB patients were collected, and named as group A and group B, respectively. Chemiluminescence method was used for hepatitis B five items detection. Real-time PCR method was used for HBV DNA quantification, and S gene was amplified by nested PCR and sequenced by DNA sequencing.Results:The level of HBV DNA in group A was significantly lower than that in group B ( P<0.05), and there were no significant differences in the serological result between the two groups. The mutation rate in the " a" determinant of S gene in group B was significantly higher than that in group A ( P<0.05). Conclusions:Compared with CHB patients, OBI blood donors have lower levels of viral replication and less chance of S gene mutation, and the use of highly sensitive nucleic acid detection reagents and method during blood screening can maximize the safety of blood transfusion.

Objective:To explore the application of nested PCR in the detection of occult hepatitis B virus infection (OBI) in blood donors, and improve the detection rate of OBI in blood screening before blood transfusion.Methods:From July 2021 to August 2022, 37 blood donors who donated blood in our center were found to have HBsAg- and nucleic acid testing (NAT)+ by serological tests and nucleic acid amplification tests. The CT value of nucleic acid amplification test was recorded, and the HBV DNA was quantitatively detected by fluorescent quantitative PCR; Conventional PCR primers and nested PCR primers were designed to amplify HBV S gene and pre-S gene using conventional PCR and nested PCR respectively, and gene sequencing was performed for the amplification result.Results:Among the 37 HBsAg- and NAT+ blood donors, 33 nucleic acid detection CT values were in the gray area, and the fluorescent quantitative PCR detection of HBV DNA value was negatively correlated with the nucleic acid detection CT value; 37 cases of HBsAg-, NAT+ blood donors could not be amplified by conventional PCR. After using nested PCR, 34 cases could detect the S gene of HBV virus, and 28 cases could detect the pre S gene of HBV virus; The amplified bands were all HBV genome bands by gene sequencing.Conclusions:The plasma HBV viral load of HBsAg- and NAT+ blood donors was very low; nested PCR has high sensitivity, which can improve the detection rate of HBV S gene and pre-S gene, and has certain application value for the pre transfusion screening and follow-up research of OBI.

Objective:The serological characteristics and S gene sequencing of intermittent detection of hepatitis B virus (HBV) DNA from an unpaid blood donor were analyzed to provide a basis for correct interpretation of intermittent detection of HBV DNA from blood donors and better guarantee of blood safety.Methods:The samples of blood donors with intermittent detection of HBV DNA were collected for two blood donations. ELISA was used to detect HBsAg and NAT screening for HBV DNA. Electrochemical luminescence method was used to detect five items of hepatitis B. Nested PCR was used to amplify the HBV S gene, and gene sequencing was performed. Genotype and mutation were compared and analyzed.Results:HBsAg was negative in both samples by ELISA.NAT result were non-reactive once and reactive once. Hepatitis B e antibody (Anti-HBe) and hepatitis B core antibody (Anti-HBc) were positive. The same S gene sequence was obtained from two samples of the donor by amplification and sequencing, and the genotype was HBV genotype C. No mutation was found in the reference sequence comparison with S gene.Conclusions:The donor has occult HBV infection (OBI), which is manifested as intermittent detection by routine screening nucleic acid detection reagent, which is easy to miss HBV detection and seriously affects the safety of transfusion. Sensitive screening reagents and method are very important for the safety of blood transfusion.